Pregnant women with HIV go untreated for depression

Rajesh Balkrishnan, an associate professor at the University of Michigan College of Pharmacy, has found that pregnant women who are infected with HIV/AIDS are frequently not screened for depression. Balkrishnan also has an appointment in the School of Public Health at the Ann Arbor-based institution, where he studies health disparities. "We find that many of these things are such common sense that they should already be in place and being done," said Balkrishnan. "Yet, time and again, we find nothing is being done, though these problems exist."

Balkrishnan and co-authors of the paper entitled, "Racial Differences in Perinatal Depression among HIV-Infected Women," in the online Health Outcomes Research in Medicine journal, found that approximately 28 percent of the low-income, HIV-positive pregnant women reported symptoms of depression. The numbers could be much higher because the study only captured the women who were being treated for depression.

In the study, about 20 percent of the 431 African-American women and 43 percent of the 219 white women reported depression. However, the incidence of depression may be higher for African-American women. Balkrishnan said, however, that the incidence of depression could be higher for African-American women—twice as many of whom are on Medicaid and pregnant compared to whites.

Studies in the past have shown that African-American women are less likely to seek treatment or report symptoms of depression in the first place. In addition, they are more likely to report physician stereotyping and sometimes a general mistrust of physicians and providers of medical assistance. The studies appear to show that they do not receive the same quality of care as white women, according to the University of Michigan.

Balkrishnan said that this means when African-American women do report depression, they may not be taken seriously or receive the best treatments. According to a University of Michigan release, physicians also have reported feeling undertrained to communicate with African-American and nonwhite women about depression.

"Because African-American women are less likely to seek treatment for their depression, it makes it even more of an issue," Balkrishnan said. "Basically, the takeaway is that depression is very common in this very vulnerable population. I think we need to make sure depression is screened and treated in this population."

Depression, if untreated, can lead to suicide or alcohol and drug abuse that may harm the mother and/or her unborn child.